Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor

Mov Disord. 1995 May;10(3):318-28. doi: 10.1002/mds.870100315.


Stereotactic lesions in the thalamus for treatment of parkinsonian tremor are often made at the location where neurons fire at approximately tremor frequency (tremor cells). Some of these cells show a large amount of activity at tremor frequency and are significantly correlated with electromyographic activity (EMG) during tremor. Our analysis of cellular location identifies a cluster of neurons showing activity characterized both by concentration of power at tremor frequency and by significant correlation with EMG. In a retrospective analysis of results in 15 patients, lesions placed within 2 mm of the center of this cluster were uniformly effective in relieving tremor. Therefore, a small lesion targeting this cluster is effective in treatment of parkinsonian tremor.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Brain Mapping / methods*
  • Confidence Intervals
  • Electromyography / statistics & numerical data
  • Evoked Potentials / physiology
  • Fourier Analysis
  • Humans
  • Mathematical Computing*
  • Neurons / physiology
  • Parkinson Disease / physiopathology
  • Parkinson Disease / surgery*
  • Retrospective Studies
  • Signal Processing, Computer-Assisted*
  • Stereotaxic Techniques / statistics & numerical data*
  • Synaptic Transmission
  • Thalamic Nuclei / physiopathology
  • Thalamic Nuclei / surgery*
  • Treatment Outcome
  • Tremor / physiopathology
  • Tremor / surgery*